NPI 1053541607

Iyla Tikhonov, CSA

Practitioner Surgical Physician Assistant Falls Church, VA

Practice location

Address: 3300 Gallows Rd, Falls Church, VA 22042-3307
Phone: (703) 776-4094
Mailing address: 3378 Woodburn Rd APT T3, Annandale, VA 22003-6817

Registered specialties

Surgical Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363AS0400X Licence 06-228 (VA)

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Registry record

NPI: 1053541607
Entity type: Individual
Sex (as registered): Male
NPI issued: 16 Jul 2009
Record last updated: 21 Jul 2009

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.